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目的:分析发生剖宫产子宫切口撕裂的相关因素及临床处理措施,以降低剖宫产切口撕裂率及术后病率。方法:回顾性分析东阳市妇幼保健院产科2006年1月~2008年12月3 657例施行剖宫产产妇的临床资料。结果:3 657例剖宫产产妇中,切口撕裂90例。90例中,麻醉效果不佳者20例,占22.22%,而切口未撕裂组麻醉效果不佳者仅占1.74%,两组比较有统计学差异(P<0.05)。另外,宫口扩张≥8 cm,胎先露≥+2 cm,胎方位为枕后位或枕横位、胎头深固、子宫下段形成差,瘢痕子宫的产妇,切口撕裂明显增加。结论:子宫下段横切口撕裂是剖宫产术常见的并发症,严密产程监护,选择最佳手术时机,是防止切口撕裂的关键。
Objective: To analyze the related factors of cesarean section uterine incision and its clinical treatment to reduce the rate of incision and postoperative cesarean section incision. Methods: A retrospective analysis of Dongyang City Maternal and Child Health Hospital Obstetrics and Gynecology January 2006 ~ December 2008 3 657 cases of cesarean section delivery of clinical data. Results: 3 657 cesarean section women, incision 90 cases of incision. Among the 90 cases, 20 cases had poor anesthesia, accounting for 22.22%, while those with poor anesthesia in the incision without rupture accounted for only 1.74%. There was a significant difference between the two groups (P <0.05). In addition, the uterine cervix expansion ≥ 8 cm, fetal first revealed ≥ +2 cm, fetal position for the occiput posterior position or occipital transverse position, the fetal head deep solid, lower uterine segment formation, scar uterine maternal, incision tear increased significantly. Conclusion: The transverse incision in the lower uterine segment is a common complication of cesarean section. The strict supervision of labor and choosing the best timing of the operation are the keys to prevent the incision.